Topics in Pediatric Leukemia -- Acute Lymphoblastic Leukemia

Samuel D. Esparza, MD; Kathleen M. Sakamoto, MD, PhD

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Introduction

Acute leukemia is the most common childhood malignancy, which accounts for approximately one third of all pediatric cancers. Acute lymphoblastic leukemia (ALL) constitutes about 75% of pediatric acute leukemias. The incidence of ALL in the United States is approximately 3.4 cases per 100,000 individuals less than 15 years of age. The peak incidence of childhood ALL occurs between ages 3 and 4.[1,2] In the United States, the incidence of ALL is higher in whites than in African Americans by a ratio of 1.8: 1. In addition, ALL is slightly more common in boys than in girls.[3,4]

Genetic factors may predispose children to develop leukemia. Germline chromosomal abnormalities have been associated with childhood leukemia.[5,6,7] Environmental factors, eg, exposure to pesticides and herbicides; maternal use of alcohol, cigarettes, and contraceptives; and chemical contamination of groundwater have all been studied, although no definitive link to the development of childhood ALL has been established.[8,9]

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